Bengaluru: Rajath (name changed) walked into a city hospital after almost seven years of being affected by a skin condition. Sadly, he took numerous blood tests to find out the cause of the infection and passed it off as eczema or psoriasis.
"Rajath walked in for treatment of a skin infection, for which he had been taking medicines for eczema and psoriasis for almost seven years. He also took numerous blood tests but could not find the real cause. To his shock he finally discovered he was suffering from tuberculosis of the skin," says his treating doctor Dr Sachith Abraham, Consultant Dermatologist and HOD at the dermatology department, Manipal Hospital.
This disease that is commonly associated with the lungs, can also be equally invasive and harmful to the skin. Tuberculosis, MTB, or TB, typically attacks the lungs, but can also affect other parts of the body, including the skin. "It is not as common as lung TB, but it can be caused by direct infection on the skin by the TB bacteria. It depends on a person's immunity. Cutaneous lesions are relatively uncommon manifestations of TB, occurring in only 1 to 2 percent of infected patients. The clinical findings vary: inflammatory papules, verrucous plaques, suppurative nodules, chronic ulcers, or other lesions may be seen," points out Dr Sachit.
These are painful cutaneous tuberculosis skin lesions with nodular appearance, most often seen on the face around the nose, eyelids, lips, cheeks, ears (both) and neck. However, Rajath was hesitant to do another biopsy. "He was very reluctant. In fact, he had done a biopsy 34 times and it showed nothing. But we asked him to do another biopsy, a skin test and the result came that he was suffering from TB of the skin," said Dr Sachit. "The doctors should have a high index of suspicion in such cases," he adds, as he explains the uncommon nature of the disease.
Rajath is however on a long-term treatment plan which consists of anti-tuberculosis medication. "He is on medication and the illness is regressing. Generally it is a lengthy treatment. And, without treatment, the lesions slowly spread laterally, leading to disfiguring scarring. Malignant changes have been reported in these scars, leading sometimes to disfigurement of the face. In rare instances it can cause cancer."